LEAD BY EXAMPLE: Evaluation of an NCCN and ASCO guideline-based virtual weight loss and healthy lifestyle intervention on providers and staff members at a comprehensive cancer center.
Authors: Damien Mikael Hansra, Jacqueline Boodhoo, Anya Warren, Shanetia Avinger, Eyal Meiri
Journal: Journal of Clinical Oncology (2022)

e24045 Background: Obesity is a leading cause of preventable death in the United States. The incidence of most obesity associated malignancies are increasing. Novel interventions to combat the obesity epidemic are greatly needed. Here we investigate the effect of a virtual clinical intervention on medical providers &amp; other medical staff at a comprehensive cancer center. Methods: Physicians (MD), nurses (RN), &amp; other medical staff (MS) were enrolled in an IRB approved, prospective single arm clinical trial. We assessed the effect of NCCN &amp; ASCO guideline recommendations for weight loss &amp; healthy lifestyle on overweight (OW) &amp; obese (OB) providers &amp; medical staff. Primary outcome: to assess change in body mass index (BMI) over a 3-month (mo.) intervention. Secondary outcomes: To assess changes in nutrition and exercise habits over time b) evaluate other lifestyle factors over time: stress, self-image, barriers to weight loss. Participants (Pts) filled out two 16 question (Q) pre &amp; post survey (at 1, 90 days) relating to study outcomes. The virtual intervention consisted of giving information &amp; advice over 3 months: A comprehensive handout e-mailed on day 1 + Motivational/info e-mails q 2 weeks/3 mo. Statistical analysis: students' paired T test used to compare changes in weight &amp; survey responses day 0-90. P- value α = 0.05. Inclusions: age &gt; 18 yo males &amp; females, MD, RN, ARNP, &amp; MS who are OW (BMI &gt; 25Kg/m2) or OB (BMI &gt; 30Kg/m2). Exclusions: non-OW/OB, Pts with uncontrolled cardiovascular, pulmonary, orthopedic, or cerebrovascular disease, pregnancy. Results: 106 participants enrolled; 26 subjects completed study. Demographics: 6/26 = 23% (MD/ARNP), 12/26 = 46% (RN), 8/26 = 31% (MS). 4/26 = 15% male, 22/26 = 85% female, µ age 45 (25-67). 3/26 = 12% Asian, 5/26 = 19% Black, 18/26 = 69% White. 100% not Hispanic. µ BMI = 33.9 kg/m2 (25.1-44.5). Intervention: 26/26 (100%) Pts lost weight/3 mo., µ Δ kg = -5.2kg (p &lt; 0.0001), µ Δ BMI = - 1.67 kg/m2 (p = 0.002). Survey results: Significant improvements were seen in: self-image (p = 0.0012), physical activity (p &lt; 0.0001), healthy diet (p &lt; 0.0001), days/week exercise (p = 0.0008), µ Δ minutes exercise/week = +65 min/week (p = 0.0046), decreased stress levels (p &lt; 0.0001). Limitations: significant participant drop out seen. Conclusions: All participants who completed the study lost weight &amp; improved healthy lifestyle parameters. To our knowledge this is the first all virtual clinical weight loss &amp; lifestyle intervention executed. Also, this is the first weight loss &amp; lifestyle intervention executed in providers. Our intervention was cost effective, easy to execute, &amp; warrants further study in both medical staff &amp; patient populations. Last, this novel virtual intervention is highly relevant during the covid 19 pandemic due to social distancing requirements.